Stago Compact型血液凝固分析仪的抗干扰功能

目的 :对法国Stago公司生产的StagoCompact血液凝固分析仪的抗干扰能力进行试验研究。方法 :重复测定正常人外观血浆凝血酶原时间 (PT)、部分凝血活酶时间 (APTT)和纤维蛋白原定量 (Fg)各 10次 ;采用日本统一标准干扰物 (溶血性血红蛋白、直接胆红素、间接胆红素和乳脂蛋白 )分别加入试验血浆中 ,再测定各种浓度干扰物 试验血浆的PT、APTT和Fg。结果 :PT、APTT和Fg重复测定的CV <1 0 % ;测定干扰物试验血浆PT、APTT和Fg的影响范围在± 3 4 %。结论 :该仪器具有较好的抗溶血性血红蛋白、直接胆红素、间接胆红素和乳脂蛋白干扰的能力。     

STA-COMPACT型全自动血凝仪抗干扰能力探讨

目的:对STA-COMPACT型全自动血凝仪的抗溶血、脂浊、黄疸干扰能力进行试验研究。方法:重复测定正常水平定值血浆和异常水平定值血浆各10次,采用干扰物(溶血性血红蛋白、脂肪乳和胆红素)分别加入试验血浆中,再测定各种浓度干扰物试验血浆的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)和纤维蛋白原(FIB)。结果:APTT、PT、TT和FIB重复测定的影响度都≤2.5%,测定干扰物试验血浆APTT、PT和TT的影响范围在±5.2%内,FIB的影响范围在±8.3%内。结论:该仪器具有较好的抗溶血性血红蛋白、脂浊、黄疸干扰的能力。     

CA 1500型血液凝固分析仪的抗干扰功能

目的　对日本 Ｓ Ｙ Ｓ Ｍ Ｅ Ｘ 公司生产的 Ｃ Ａ１５００ 血液凝固分析仪的抗干扰能力作试验研究。方法　重复测定正常外观血浆凝血酶原时间（ Ｐ Ｔ） 、部分凝血活酶时间（ Ａ Ｐ Ｔ Ｔ） 和纤维蛋白原定量（ Ｆｉｇ）各１０ 次;采用日本统一标准干扰物（ 溶血性血红蛋白、直接胆红素、间接胆红素和乳脂蛋白） 分别加入到试验血浆中,再测定各种浓度干扰物试验血浆的 Ｐ Ｔ、 Ａ Ｐ Ｔ Ｔ 和 Ｆｉｇ 。结果　重复测定 Ｐ Ｔ、 Ａ Ｐ Ｔ Ｔ 和 Ｆｉｇ的 Ｃ Ｖ＜ １ ．５ ％ ;测定干扰物试验血浆 Ｐ Ｔ、 Ａ Ｐ Ｔ Ｔ和 Ｆｉｇ 的影响范围在±３ ．７ ％ 。结论　该仪器具有强力抗溶血性血红蛋白、直接胆红素、间接胆红素和乳脂蛋白干扰的能力。     

常见内源性干扰物对凝血试验结果的影响分析

目的 分析常见内源性干扰物对凝血试验结果的影响，为临床判断凝血结果异常提供准确的实验室依据。方法 收集表观健康成人血浆50份制成正常混合血浆(NPP),使用干扰物检测试剂盒中的胆红素F、胆红素C、血红蛋白、乳糜模拟内源性干扰物，将干扰物与NPP以不同比例混合配制成含不同浓度干扰物的血浆标本，以加入空白干粉液的NPP作为对照，在Sysmex CS-5100全自动凝血分析仪上检测血浆活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D-二聚体(DD)。结果 当胆红素F血浆浓度在0～207.50μmol/L时APTT结果不受影响，在0～518.76μmol/L时PT、TT、FIB、DD检测结果不受影响；胆红素C血浆浓度在0～271.60μmol/L时Fib检测结果不受影响，在0～543.20μmol/L时APTT、PT、TT、DD检测结果不受影响；血红蛋白血浆浓度在0～98.88 mg/dL时DD检测结果不受影响，在0～247.20 mg/dL时APTT、PT、TT、Fib检测结果不受影响；乳糜血浆浓度在0～3 382.56 Ftu时APTT检...     

CA 1500型血液凝固分析仪的抗干扰功能

对日本ＳＹＳＭＥＸ公司生产的ＣＡ１５００血液凝固分析仪的抗干扰能力作试验研究。方法重复测定正常外观血浆凝血酶原时间、部分凝血活酶时间和纤维蛋白原定量各１０次;采用日本统一标准干扰物分别加入到试验血浆中,再测定各种浓度干扰物－试验血浆的ＰＴ－ＡＰＴＴ和Ｆｉｇ。结论该仅器具有强力抗溶血性血红蛋白,直接胆红素、间接胆红素和乳脂蛋白干扰的能力。     

60例新生儿高胆红素血症凝血功能分析

新生儿高间接胆红素血症已成为最常见的新生儿疾病之一。本文收集了60例高间接胆红素血症新生儿的血浆，进行凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）检测和血小板计数（PLT），旨在探讨新生儿高胆红素血症凝血功能变化，报道如下。     

XNY-01型血凝分析仪的性能评价

目的对上海蓝杰科学有限公司研制生产的XNY-01型半自动血凝分析仪的主要性能及相关指标进行评价.方法精密度评价包括(1)批内精密度试验凝血因子水平高值(正常人混合血浆)及用生理盐水适当稀释得中值及低值标本,进行活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和凝血酶时间(TT)测定.(2)批间精密度试验同上方法制得常值、中值及低值的混合血浆分装10份,储存于-70°C,每天取1份测APTT、PT和TT.(3) 相关性比较采用相同试剂与Sysmex CA-1500分析仪作相关性比较,评价APTT和PT.采用日本统一标准干扰物(直接胆红素、间直接胆红素、乳脂蛋白)分别加到试验血浆中,再分别测定APTT、PT和TT.结果批内精密度试验APTT和PT的CV<3.1%,TT的CV<5.0%.批间精密度试验APTT和PT的CV<4.0%.相关性比较APTT和PT测定结果的相关系数r均在0.97以上.干扰试验结果表明XNY-01半自动血凝分析仪具有良好的抗干扰性能.结论 XNY-01半自动血凝分析仪性能可靠,适合于标本量不太多的临床实验室应用.     

XNY-01型血凝分析仪的性能评价

目的　对上海蓝杰科学有限公司研制生产的XNY 0 1型半自动血凝分析仪的主要性能及相关指标进行评价。方法　精密度评价包括 :(1)批内精密度试验 :凝血因子水平高值 (正常人混合血浆 )及用生理盐水适当稀释得中值及低值标本 ,进行活化部分凝血活酶时间 (APTT)、凝血酶原时间 (PT)和凝血酶时间 (TT)测定。(2 )批间精密度试验 :同上方法制得常值、中值及低值的混合血浆分装 10份 ,储存于 - 70°C ,每天取 1份测APTT、PT和TT。 (3)相关性比较 :采用相同试剂与SysmexCA 15 0 0分析仪作相关性比较 ,评价APTT和PT。采用日本统一标准干扰物 (直接胆红素、间直接胆红素、乳脂蛋白 )分别加到试验血浆中 ,再分别测定APTT、PT和TT。结果　批内精密度试验 :APTT和PT的CV <3.1% ,TT的CV <5 .0 %。批间精密度试验 :APTT和PT的CV <4 .0 %。相关性比较 :APTT和PT测定结果的相关系数r均在 0 .97以上。干扰试验结果表明XNY 0 1半自动血凝分析仪具有良好的抗干扰性能。结论　XNY 0 1半自动血凝分析仪性能可靠 ,适合于标本量不太多的临床实验室应用。     

BE血凝仪抗干扰能力评价与处理

目的探讨BE血凝仪对溶血、脂肪乳、黄疸的抗干扰能力和解决方法。方法制备正常新鲜混合血浆并重复测定凝血酶原时间（PT）和部分凝血活酶时间（APTT）;在正常新鲜混合血浆中加入不同浓度溶血、脂肪乳和黄疸干扰物并重复测定其PT和APTT,取均值计算干扰物影响度。结果当添加干扰物脂肪乳〉5％时,仪器不能给出PT结果并报警。此外,不同浓度溶血和黄疸干扰物对PT、APTT影响度〈±15％,未超过美国CLIA’88规定的允许偏差度。结论BE血凝仪具有对溶血、黄疸的抗干扰能力,对重度脂血的抗干扰能力有限,重度脂血标本可采用非光学法血凝仪进行复杏。     

不同胆红素浓度对血浆凝血酶原时间与活化部分凝血活酶时间检测的影响

目的探讨不同胆红素浓度对血浆凝血酶原时间（PT）与活化部分凝血活酶时间（APTT）检测结果的影响,进而得出校正公式。方法对不同TBIL浓度的质控血浆进行血浆PT和APTT的测定,并用二次回归方程得出校正公式。结果当胆红素浓度低于20μmol/L时,对血浆PT和APTT检测结果的影响差异无统计学意义（P〉0.05）;随着胆红素浓度的增高,PT和APTT的检测结果随之升高。结论胆红素浓度轻度增高的血浆对PT结果的影响不大,但胆红素浓度明显升高的血浆可能会对PT和APTT检测结果产生干扰。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."